Middle East Coronavirus Respiratory Syndrome (MERS-CoV) – United Arab Emirates

On January 9 and 13, 2020, the United Arab Emirates (UAE) IHR National Contact Point reported to the WHO two additional (2) laboratory confirmed cases of Middle Eastern Respiratory Syndrome Coronavirus (MERS-CoV).

The link below contains information on 2 reported cases:

The first MERS-CoV case in the United Arab Emirates (UAE) was reported in July 2013. Since then, the UAE has recorded 91 MERS-CoV cases (including these cases) and 12 related deaths. From 2012 to January 15, 2020, the total number of MERS-CoV confirmation cases of MERS-CoV infection recorded globally by WHO is 2506 with 862 associated deaths. The total number of deaths includes deaths of which WHO is aware to date through the monitoring of affected Member States.

Public health response

After identifying the cases mentioned, an incident report, an investigation of the case, and a search for contact were launched. The investigation included a review of all close contacts, including professional contacts on two farms, household contacts and health care professionals in healthcare facilities. All close contacts were tested for MERS-CoV and the results were negative. All of them are monitored daily for respiratory or gastrointestinal symptoms for 14 days after the last exposure to confirmed cases. Veterinary authorities have been notified and an animal investigation is ongoing.

WHO risk assessment

Infection with MERS-CoV can cause serious illness resulting in high mortality. Humans are infected with MERS-CoV direct or indirect contact with dromedary camels. MERS-CoV showed limited ability to transmit between humans. Until now, the observed unsupervised human-to-human transmission has taken place mainly in healthcare facilities.

Notification of additional cases does not change the overall risk assessment. WHO expects additional MERS-CoV infection cases to be reported from the Middle East and that cases will continue to be exported to other countries by individuals who may become infected after exposure to dromedary camels, animal products (for example, by consuming camellian raw milk) or people (for example, in a healthcare facility).

WHO continues to monitor the epidemiological situation and conduct risk assessments based on the latest available information.

Tip of WHO

Based on the current situation and the information available, WHO encourages all Member States to continue monitoring acute respiratory infections and to carefully review any unusual patterns.

Infection prevention and control measures are key to preventing the possible spread of MERS-CoV in healthcare settings. It is not always possible to identify patients with MERS-CoV infection early because, like other respiratory infections, the early symptoms of MERS-CoV infection are not specific. Therefore, healthcare professionals should always apply standard precautions consistently to all patients, regardless of diagnosis. Capital measures should be added to standard precautions for the care of patients with symptoms of acute respiratory infection; contact precautions and eye protection should be added when caution is likely or confirmed in MERS-CoV infection; air precautions should be taken when performing aerosol generation processes.

Early identification, case management and isolation, together with appropriate infection control and suppression measures, can prevent the transmission of MERS-CoV from person to person.

MERS-CoV appears to cause more severe illness in people with underlying chronic conditions such as diabetes, renal failure, chronic lung disease, and impaired people. Therefore, these people should avoid close contact with animals, especially dromedary camels, when visiting farms, markets or stalls where the virus is known to circulate. General hygiene measures should be observed, such as washing hands regularly before and after touching animals and avoiding contact with diseased animals.

Food hygiene practices should be followed. People should avoid drinking raw camel milk or camel’s urine or eating meat that is not properly cooked.

WHO does not advise special entry point review with respect to this event, nor does it currently recommend the application of any travel or trade restrictions.